Genug with Sitting Shivah

There is a tradition among my people: when a loved one passes away we spend seven days in mourning. We call it Sitting Shivah. "Shivah" means seven in Hebrew. During this time we abstain from common daily luxuries, pleasurable activities, and even cover the mirrors so as to avoid vanity. This period is set aside  to focus not only on what we lost but to work through the pain and anger of that loss.

As of today, it's been a week since I learned that I failed my medical boards again. While it is true that this loss does not compare to the loss of a loved one, it is painful loss nonetheless. Today, it was made even more painful learning, because of the delay in passing my exam, that I will not be able to graduate with my class. So, instead of graduating in 2018 I will walk in 2019.

The pain of these compound losses strikes deep within me. The mantra "You're a failure." plays over and over in my mind. I see my family suffer financially because of my current inability to get over this hurdle.

But Shivah is over now. I can no longer afford the luxury of self-pity. The time for wallowing in depression has passed. Now is the time for action. After consulting with faculty at my medical school, as well as my advisors, my family and I have developed an aggressive plan, a new approach, so as to pass the board exam this next time, God willing. My school allows four attempts to pass before I am expelled. It is my sincere hope that I will not have to avail myself of every one of those attempts.

So, time to dry my eyes, time to let go of the self-anger, time to replace the destructive mantra of failure with a mantra of hope. If there was ever a time to "pull myself up by my bootstraps" it is now. I have wanted to be a doctor since I was six years old. I am sure not going to let one stupid test rip this away from me.

So help me God.

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Nuts!

On December 22nd, 1944, the US Army was in the Belgian city of Bastogne, surrounded by the German Army. World War II was winding down and the Germans expected an easy victory against the American F Company of the 327th Glider Infantry Regiment, 101st Airborne Division. So sure was the German Army of their pending success that they typed a formal letter to the Americans asking the Yanks to surrender. US General Anthony McAuliffe, after reading the letter, gave his now famous response to the request: "Nuts!" Indeed, the good general had his terse reply typed up in a formal memorandum and sent to the German Army. Initially they did not understand General McAuliffe's reply so the Americans spelled it out for them: they were decidedly not going to surrender. Remarkably, the US Army survived a scaled down German attack and the rest, as they say, is history.

Yesterday, I received the results of my second COMLEX step 1 medical boards exam. Incredibly, and against all odds, I failed yet again. This makes two consecutive failures of my medical boards - a profoundly negative turn of events. The discouragement and shock are intense, as you could imagine.

Now there are pressing questions: should I go on? Would I be a fool for continuing this marathon toward becoming a physician? Am I, at this point, simply putting off the inevitable reality that I simply cannot make it?

Someone once said that the true timbre of a man is determined by the manner in which he handles his failures as much as his successes and I believe this to be true. I am not under the illusion that I am not in a most difficult position. Two failures look very bad on my transcripts and are a definite big bump in the road when it comes to residency applications. On top of all of this, my family is suffering as finances become increasingly strained. Would it be fair to them for me to try yet again?

Needless to say my family and I have been in much prayer. I have consulted with one of the deans of my school and with multiple professors. My family, friends, and faculty all tell me the same thing: don't give up. Don't surrender.

I am surrounded. The enemy is pressing in on every side. I am assaulted by failure, fears, and financial strain. These formidable foes have told me to turn in my stethoscope, told me it's time to move on to something else...

Nuts!

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The Medieval Torture that is COMLEX

This post is going to be a little longer than normal.

On September 19th, I had the joy (*ahem*) of taking the Osteopathic Medicine Step 1 boards exam, the COMLEX, again. I wanted to share with you, Dear Reader, my experience that day.

I woke up early after attempting to get a full night's sleep. My family was with me as I had a high protein breakfast and they dropped me off at the Prometric Testing Center. I confess I was nervous, though not nearly as nervous as the first time. (For those who may not know, I failed my first Step 1 boards attempt). My wife prayed with me and, with that, I stepped through the glass front door of the Center.

I signed in and was assigned a small locker into which I stored my cell phone and keys. I was led into another room where a friendly if not slightly bored person asked me to turn my pants pockets inside-out, lift my pant legs to reveal my ankles, and turn about as she waved a magic wand up and down my body searching, no doubt, for some metallic tablet onto which I might have engraved two years worth of medical knowledge. After being satisfied that I wasn't a felon, I was asked to sit down next to another friendly person who scanned my fingerprints on both hands. He asked for a picture ID. I obliged. After several minutes of him scanning my ID and tapping vigorously into his computer, I was given the "go-ahead". I had cleared Security. I could take the test! Whoo-hoo!

I was given a couple of permanent markers and several plastic sheets of paper and led into a tomb-like, windowless room filled with several cubicles, each of which had an outdated computer and simple chair. I sat down, listened to some simple instructions from the friendly lady who would monitor this room for the next eight hours, and was shown a pair of earphones. After being assured that I had everything I needed, she left.

This was it. I stared at the monitor. It stared back. Months and months of study and preparation came down to this moment. I took a deep breath, said another quick prayer, and clicked on the "Start" button. The first question came up. I read it quickly, scanned the answer options and, to my delight, actually understood what was being asked of me! This was a good start.

Four hours later I had finished 200 questions and felt, honestly, pretty good. I was not anxious as I had been the first time, and I was ready for a quick lunch break. I stood, left the earphones and plastic sheets at my station, and walked out to the bored attendant. He scanned my fingerprints (just in case I had magically morphed into a different person while sitting in my cubicle. One can never be too careful), made sure I had my ID, and let me go to lunch.

In the parking lot, my wife and kids had returned and we sat in our beat-up minivan together while I quickly downed a protein bar and bottle of water. My wife wanted to know all about my experience thus far and I was happy to report that I felt pretty good. After 20 minutes and another prayer, I was back in the testing ante-room, getting scanned, fingerprinted, and ID'd. Soon I was sitting at the desk and ready to resume.

And then I hit the wall.

My shoulders started to tense, my neck started to ache and, after a couple of dozen questions, I found myself having to read each question twice to understand what was being asked. The clock seemed to supernaturally speed up as I struggled to finish on time. What was wrong? What had changed? I felt anxiety begin to gnaw at the edges of my mind. I fought it back, took a deep breath, said another prayer (I'm convinced in the therapeutic power of prayer) and pushed ahead. I read another question. What the heck was it asking? I had to look up several lab results. The clock seemed to run even faster. I finished another set of 50 questions, leaned over in my chair, stretched my back, did a quick OPP treatment on my neck, and looked back at the screen, challenging it. I would conquer this stupid thing, so help me God. I heard a truck pass by noisily outside. Behind me, another test-taker was tapping his desk nervously. Great...

An additional four hours passed and I came to the final question. By this time, I was exhausted and, honestly, I could barely force myself to care. I looked at the answer options, realized I had no clue, and quickly clicked what I thought might be the right answer. The clock told me I had a couple of minutes left. I closed the test.

I was done.

I stood. My legs and hips groaned in protest. What had begun eight hours ago with confidence and enthusiasm ended with a sense of completion and exhaustion. I stretched, waved at the poor attendant who watched me through the glass, and left the room. More fingerprints, more ID confirmation. I went to my locker, grabbed my phone, turned in my locker key, and walked out. In a few moments my family showed up, ushering me away to a celebratory dinner.

Regardless of the results, I know it is a great honor to be given the opportunity to sit for the medical boards. And I, ever the over-achiever, sat for them twice. Now my family and I wait a month for the folks at the NBOME to process and post the results. I feel hopeful (more so than the first time) that I passed and can move forward to third year rotations. There remains in me an anxiety that I may have failed a second time, an anxiety shared, I've learned, by most of my classmates who later learned they passed. I am using this interim waiting time to sleep in and spend time with my family.

Thank you, Dear Reader, for making it thus far in this, my longest blog entry ever.

I will keep you posted!

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